Remission from daily stomach pain and ulcerative colitis has been a hard won victory for me, but it was undone in a mouthful. A family holiday to Vietnam earlier this year brought back a world of familiar tummy pain.
Who knows what I ate? On the 3rd day whilst my family frolicked on the beach, I lay low and kept desperately close to the loo. It was only a 24 hour thing but it impacted me for weeks with constipation and diarrhoea, painful bloating and continual stomach tenderness. These are common digestive upsets that indicate something is out of balance. It was time to investigate further.
I felt sure I had a parasite. That would have been the simplest explanation. Back home, tests came back negative. My gut had a history of being more complex than that.
I had been keen to have a Bioscreen, Faecal Microbial Analysis (FMA) for years but the price had always discouraged me. Actually, to be honest, I thought I was all good without it. Intellectually, I new what was required for gut health; ‘A Gut Feeling’ had me on top of the news. I’d changed my diet dramatically already, I’d done years of gut healing with significant results. I’d been in remission from ulcerative colitis for 3 years. Until this traveler’s hiccup, I actually thought I was doing ok, microbially that is.
Why I wanted to know what was actually living inside my gut.
I’m damn curious. (Parasites and poo are a dinner table favourite). No, seriously, I had a lot of questions….. I’d struggled with IBS and colitis for 20 years. Did I have an abundance of bad bacteria? Could this explain why my symptoms seemed to never fully resolve, or at least, came back so quickly? I’d taken a truck load of antibiotics in my life and been a total sugar addict!
So what is a Faecal Microbial Analysis?
FMA is a specialist stool test that investigates the microscopic gut flora of the lower intestinal tract. It cultures and counts the bacteria that should be in your gut. The test measures aerobes and anaerobes, 2 significant bacteria groups (read about them here) plus the yeast living in the colon.
It is different to the common stool tests from your GP (faecal bacteriology and parasitology tests) which check for abnormal bacteria and parasites that shouldn’t be in your gut. This is what I’d had to check for parasites.
The analysis provides quantitative data on microbial strains and shows imbalances between what is known to be good and bad in your intestinal ecosystem. An impressive 5000 organisms are screened, however, only a small fraction of these are likely to be hanging out in your gut and end up on the report.
It’s all about balance.
The ratio of good to bad bacteria is not only a critical measure in determining your gut health but your overall health! An ideal balance is about 85 percent good and 15 percent bad. And, It’s not necessarily the presence or absence of one particular type of bacteria that makes for a healthy microbiome. Diversity is the key.
In very basic terms, here’s summary of my report:
Bad, disease causing bacteria.
I didn’t have any?
So, I didn’t have an overgrowth of pathogenic bacteria (the seriously bad guys) A part of me was a bit disappointed. I was ready for a fight. I like to name and blame!
Pathogenic disease causing bacteria (H.pylori or clostrifium difficile for eg) or yeast (candida) can stop beneficial bacteria from thriving and in turn effect the proper functioning of your whole body. It’s also important to note that an overgrowth of a beneficial bacteria can cause problems as well. As I said, it’s all about balance.
The good guys. The health promoting bacteria.
I didn’t have any!!!
Oh know. I didn’t expect this news. Years of healing and eating fermented food had not improved my gut flora at all. Clearly I am leaking!!!
No good guys? What does that mean? Ok, I’m exaggerating. I did have a few meagre bacteroides, lactobacilli and Bifidobacterium but they were in alarmingly low numbers. My ‘diversity’ was pretty narrow.
Where is all the good bacteria I eat going?
It’s probably just dying off like seeds in poor soil without regular water. The report has made it obvious that my gut flora is out of balance and in poorer shape than I thought.
This is evidence enough that I have leaky gut. (I believe it exists.) I’d suspected this much for years but never imagined it could be so bad.
The most important thing I learnt about my gut flora.
I have a low and limited distribution of Bacteroides. This is a big problem and may be the key to my healing.
Bacteroides make up approximately a third of total gut flora. Humans became inoculated with bacteroides during the birth process and then through breast milk. After that, its lifestyle and diet that determines their survival – they need to be fed well to proliferate. Unlike other gut bacteria they can’t be grown (fermentated foods) or made into a probiotic. Bacteroides cannot exist outside the human gut; oxygen kills bacteroides quickly. Interestingly, the absence of bacteroides can result in serious bowel pathology. Could this may explain my ulcerative colitis??
It was suggested that low Bacteroides levels could be inhibiting other necessary strains of bacteria from flourishing.
I make homemade, 24 hour yoghurt that is full of lactobacilli. I have eaten a cup every day for nearly 3 years. I also take a probiotic with lactobacilli. Despite this, my report indicates an undergrowth of lactobacilli?? Eating more yoghurt is probably not the answer; however increasing my Bacteroide community may improve the conditions for lactobacilli to thrive? Sounds like a good experiment. The report has given me some tips on how to do this. As I said, Bacteroides are not found in a probiotic, they benefit from a bit of dedication and time in your home kitchen.
Every summary report will be different. These are the recommendations I was given:
For Low Bacteroides:
“The intake of fructo-oligosaccharides (FOS) may assist.” In other words eat diverse prebiotic foods such as vegetables, nuts and seeds.
“A general diet consisting of meat/bone broth, fish or soybean protein may assist the growth of these organisms”. If numbers of bacteroides are low then meat and meat broth provides essential building block nutrients. (source) It was recommended that I build up to at least 3 cups of bone broth a day.
“Consider the supplement of vitamin K2 to improve the growth of anaerobes. A high concentration of K2 is found in natural yoghurt, cheese and butter”.
“Consider the supplement of biotin to assist the production of fatty acids by anaerobes”. (Apple cider vinegar before meals will do this)
For low Bifidobacterium and lactobacilli sp.
“Oral probiotic supplementation may be beneficial”. It was suggested by my GP to increase lactobacilli Rhamnosus.
So it’s back to the brothery and fermented kitchen for me. I will drink broth far more than I have EVER …… more than I can possibly stomach perhaps.
The test has been a window into one small fraction of my unknown yet super important microbiome. These unexpected results are my motivation to go for broke when it comes to microbial multiculturalism. Fortunately this little world is continually shape shifting. Nothing is fixed or permanent in there. I can make bone broth, I can supplement more and I can eat more fermented foods. As with any ecosystem, it’s the community as a whole that matters. Their proliferation is going to have to start in my kitchen. I’m going to have to get busy catering for a healthy bacteria party in my gut.
Faecal Microbial Analysis – A guide to heal my gut – Is it worth the money?
$350. I think so. A sensitive gut is a forever nuisance! The results make me more determined to heal and seal. I long for the day that I can travel and eat out without fearing damage and discomfort. Some direction is helpful.
Where to get tested and how to read the report.
I had may test done by Bioscreen in melbourne. I am not affiliated with this lab. A word of advice, the report is quite tricky to interpret and uses medical terms that may need googling. It’s advisable to spend some time going through it with your GP or health guide. Like me, you will probably have loads of questions?
I’d love to hear if you have found the test worthwhile.
I can see a future when analysis of your microbiome will one day be as common as routine blood tests. Doctors could discuss results with you and the management of your gut bacteria as the foundation for your overall health plan.